Adverse Event Reporting Priorities: An Integrative Review

Falcone, Maureen L.; Stee, Stephanie K. Van; Tokac, Umit; Fish, Anne F.

doi:10.1097/pts.0000000000000945

Cited by 7 publications

(7 citation statements)

References 42 publications

(189 reference statements)

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“…Lower frequency of adverse event reporting, "Non punitive response to errors" and "Communication Openness" are another weakness points of patient safety culture in neurosurgical departments in Moldova. Maureen L. Falcone et all remarked in their study that fear of blame and retaliation are common reasons nurses and physicians do not report errors (24). The item "Staff worry that mistakes they make are kept in the personnel file" had the lowest level of positive responses and it influenced the composite score.…”

Section: Discussionmentioning

confidence: 96%

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The challenges and opportunities of patient safety culture in neurosurgical departments from the Republic of Moldova

Danu

2023

roneuro

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Neurosurgery is a high-risk speciality, so the Patient Safety Culture should become a priority to improve patient safety and the quality of medical care. The purpose of the study was to explore the perception of Patient Safety Culture (PSC) among the staff in the neurosurgical departments of the Republic of Moldova. A cross-sectional study was conducted in neurosurgical departments using the Hospital Survey on Patient Safety Culture (HSOPSC). Descriptive statistics were carried out, comprising the Cronbach "?" coefficient, frequency of positive answers (PPRs), and level of minimum and maximum of 95% confidential interval. PPRs by question and dimension were analysed overall and classified according to the Harrington scale. Medical staff from five hospitals voluntarily participated in the study. Most of the respondents rated the patient's safety grade as excellent and very good. The value of the frequency of positive responses to the dimensions of the survey varies between 37.3% (nonpunitive response to error) and 85.0% (teamwork within units). The dimensions with the highest score of the PPRs stand out: „teamwork within units”, „organizational learning- continuous improvement” and „supervisor/manager expectations and actions promoting patient safety”. The dimension with a high score of PPRs was „feedback and communication about error”. The dimensions with a satisfactory score of the PPRs were „handoffs and transitions”, „frequency of events reported”, „management support for patient safety”, „teamwork across units”, „communication openness”, „overall perceptions on patient safety”, „non-punitive response to errors” and „staffing”. For the first time in the Republic of Moldova, the perception of patient safety culture in neurosurgery departments was studied. The results reflect the positive attitude of the staff towards most dimensions of the patient safety culture. The study made it possible to highlight the strong and vulnerable points of the patient safety culture in neurosurgical departments from Moldova.

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Section: Discussionmentioning

confidence: 96%

“…Other barriers include workload, interruptions, and lack of knowledge. Also, an important barrier is providers not prioritizing as reportable if they are easily resolved (24).…”

Section: Discussionmentioning

confidence: 99%

The challenges and opportunities of patient safety culture in neurosurgical departments from the Republic of Moldova

Danu

2023

roneuro

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“…To feel free to speak up and challenge authorities is connected to safety culture [ 32 ]. Building and sustaining trust may be difficult, especially in hierarchical healthcare teams [ 6 ]. Participants in this study described how assertive leadership styles and empowering communication methods made them engage rather than withdraw from situations.…”

Section: Discussionmentioning

confidence: 99%

The anatomy of safe surgical teams: an interview-based qualitative study among members of surgical teams at tertiary referral hospitals in Norway

Vikan,

Deilkås,

Valeberg

et al. 2024

Patient Saf Surg

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Background In spite of the global implementation of surgical safety checklists to improve patient safety, patients undergoing surgical procedures remain vulnerable to a high risk of potentially preventable complications and adverse outcomes. The present study was designed to explore the surgical teams’ perceptions of patient safety culture, capture their perceptions of the risk for adverse events, and identify themes of interest for quality improvement within the surgical department. Methods This qualitative study had an explorative design with an abductive approach. Individual semi-structured in-depth interviews were conducted between 10/01/23 and 11/05/23. The participants were members of surgical teams (n = 17), general and orthopedic surgeons (n = 5), anesthesiologists (n = 4), nurse anesthetists (n = 4) and operating room nurses (n = 4). Middle managers recruited purposively from general and orthopedic surgical teams in two tertiary hospitals in Norway, aiming for a maximum variation due to gender, age, and years within the specialty. The data material was analyzed following Braun and Clarke’s method for reflexive thematic analysis to generate patterns of meaning and develop themes and subthemes. Results The analysis process resulted in three themes describing the participants’ perceptions of patient safety culture in the surgical context: (1) individual accountability as a safety net, (2) psychological safety as a catalyst for well-being and safe performance in the operating room, and (3) the importance of proactive structures and participation in organizational learning. Conclusions This study provided an empirical insight into the culture of patient safety in the surgical context. The study highlighted the importance of supporting the individuals’ competence, building psychological safety in the surgical team, and creating structures and culture promoting a learning organization. Quality improvement projects, including interventions based on these results, may increase patient safety culture and reduce the frequency of adverse events in the surgical context.

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“…Therefore, while fostering open communication and a non-punitive culture is beneficial, these measures alone may not be sufficient to significantly enhance event reporting rates. Similarly, Falcone et al [ 43 ] highlighted the positive effect of promoting open communication and non-punitive responses to error reporting on the rates at which events are reported.…”

Section: Discussionmentioning

confidence: 99%

Exploring the perception of safety culture among nurses in Saudi Arabia

Al Muharraq,

Abdali,

Alfozan

et al. 2024

BMC Nurs

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Background Medical errors and adverse events pose a serious challenge to the global healthcare industry. Nurses are at the frontline in implementing safety measures and protecting patients. This study aimed to investigate nurses’ perceptions of the patient safety culture in Saudi Arabia. Methods This cross-sectional descriptive study used convenience sampling to survey 402 nurses from various hospitals in Jazan, Saudi Arabia. The Hospital Survey on Patient Safety Culture was used for the data collection. Results Nurses reported a moderate perception of safety culture, with 60% positive responses. Teamwork had the highest safety culture rating at 77.8%, while responses to error and staffing were the lowest at 39.75% and 46.17%, respectively. Qualifications significantly predicts nurses’ safety culture rating (B = -0442, t = -4.279, p < 0.01). Positive correlations were found between event reporting frequency and communication openness (r = 0.142, p < 0.01), and patient safety grades with communication about errors (r = 0.424, p < 0.01) and hospital management support (r = 0.231, p < 0.01). Conclusions Nurses in Saudi Arabia demonstrated a strong sense of teamwork and commitment to organizational learning. However, critical areas such as staffing and error response require attention to improve patient safety.

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Adverse Event Reporting Priorities: An Integrative Review

Cited by 7 publications

References 42 publications

The challenges and opportunities of patient safety culture in neurosurgical departments from the Republic of Moldova

The challenges and opportunities of patient safety culture in neurosurgical departments from the Republic of Moldova

The anatomy of safe surgical teams: an interview-based qualitative study among members of surgical teams at tertiary referral hospitals in Norway

Exploring the perception of safety culture among nurses in Saudi Arabia

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